Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5930027 | The American Journal of Cardiology | 2016 | 7 Pages |
Abstract
Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition and plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild-to-moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12Â months. Optical coherence tomography was used to assess fibrous cap thickness (FCT) and intravascular ultrasound to assess atheroma burden at 3 time points: baseline, at 6 months, and at 12 months. Thirty-six lipid-rich plaques in 27 patients with AT 60Â mg and 30 lipid-rich plaques in 19 patients with AT 20Â mg were enrolled in this study. Low-density lipoprotein cholesterol level was significantly decreased at 6 months without further reduction at 12 months. AT 60Â mg induced greater reduction in low-density lipoprotein cholesterol compared with AT 20Â mg. Optical coherence tomography revealed continuous increase in FCT from baseline to 6Â months and to 12Â months in both groups. AT 60Â mg induced greater increase in FCT compared with AT 20Â mg at both follow-up points. The prevalence of thin-cap fibroatheroma and the presence of macrophage at 6 months were significantly lower in AT 60Â mg compared with AT 20Â mg. Plaque burden did not change significantly in both groups. In conclusion, both intensive and moderate statin therapy stabilizes coronary plaques, with a greater benefit in the intensive statin group. However, no significant changes in plaque volume were observed over time regardless of the intensity of statin therapy.
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Authors
Jingbo MD, PhD, Lei MD, PhD, Haibo MD, PhD, Rocco MD, Tsunerari MD, PhD, Yoshiyasu MD, PhD, Sining MD, Shuang MD, PhD, Shaosong MD, PhD, Hang PhD, Bo MD, PhD, Ik-Kyung MD, PhD,